Effect of Home- and Community-Based Physical Activity Interventions on Physical Function Among Cancer Survivors: A Systematic Review and Meta-Analysis

Maria C Swartz, Zakkoyya H Lewis, Elizabeth J Lyons, Kristofer Jennings, Addie Middleton, Rachel R Deer, Demi Arnold, Kaitlin Dresser, Kenneth J Ottenbacher, James S Goodwin, Maria C Swartz, Zakkoyya H Lewis, Elizabeth J Lyons, Kristofer Jennings, Addie Middleton, Rachel R Deer, Demi Arnold, Kaitlin Dresser, Kenneth J Ottenbacher, James S Goodwin

Abstract

Objective: To examine the effect of home- and community-based physical activity interventions on physical functioning among cancer survivors based on the most prevalent physical function measures, randomized trials were reviewed.

Data sources: Five electronic databases-Medline Ovid, PubMed, CINAHL, Web of Science, and PsycINFO-were searched from inception to March 2016 for relevant articles.

Study selection: Search terms included community-based interventions, physical functioning, and cancer survivors. A reference librarian trained in systematic reviews conducted the final search.

Data extraction: Four reviewers evaluated eligibility and 2 reviewers evaluated methodological quality. Data were abstracted from studies that used the most prevalent physical function measurement tools-Medical Outcomes Study 36-Item Short-Form Health Survey, Late-Life Function and Disability Instrument, European Organisation for the Research and Treatment of Cancer Quality-of-Life Questionnaire, and 6-minute walk test. Random- or fixed-effects models were conducted to obtain overall effect size per physical function measure.

Data synthesis: Fourteen studies met inclusion criteria and were used to compute standardized mean differences using the inverse variance statistical method. The median sample size was 83 participants. Most of the studies (n=7) were conducted among breast cancer survivors. The interventions produced short-term positive effects on physical functioning, with overall effect sizes ranging from small (.17; 95% confidence interval [CI], .07-.27) to medium (.45; 95% CI, .23-.67). Community-based interventions that met in groups and used behavioral change strategies produced the largest effect sizes.

Conclusions: Home and community-based physical activity interventions may be a potential tool to combat functional deterioration among aging cancer survivors. More studies are needed among other cancer types using clinically relevant objective functional measures (eg, gait speed) to accelerate translation into the community and clinical practice.

Keywords: Community-Based Research; Intervention studies; Neoplasms; Physical activities; Rehabilitation; Survivors.

Conflict of interest statement

Conflict of Interest:

While this study was funded in part by the Comparative Effectiveness Research on Cancer in Texas grant (RP140020) from the Cancer Prevention and Research Institute of Texas and the Interdisciplinary Rehabilitation Research Training Program (H133P110012) from the National Institute on Disability and Rehabilitation Research, Zakkoyya Lewis has begun to work for Beachbody on 9/9/2016, a company that may potentially benefit from the research results. Ms. Lewis has participated in study design, analysis, and completed a first draft of the manuscript prior to her Beachbody employment. This potential interest has been reviewed by UTMB’s Conflicts of Interest Committee and a management plan implemented to prevent any appearance of a conflict of interest. Any inquiries regarding this management plan can be directed to UTMB’s Office of Institutional Compliance, (409) 747–8701.